Mads Nikolaj Holten-Andersen

• Bjertnæs, Asborg Sine Aanstad; Fossum, Ingrid Nesdal; Oma, Ingvild; Bakken, Kjersti Sletten; Strand, Tor A & Holten-Andersen, Mads Nikolaj (2020). A cross-sectional study of the relationship between mental health problems and overweight and obesity in adolescents. Frontiers In Public Health.  ISSN 2296-2565.  8:334, s 1- 8 . doi: 10.3389/fpubh.2020.00334 Fulltekst i vitenarkiv. Vis sammendrag

  Background: There is a suggested coexistence between obesity and mental health discomfort in adolescence. The objective of this study was to explore if mental health indices covaried with body mass index (BMI) in adolescence and if there were gender-related disparities. Methods: Data were collected in two cross-sectional surveys of 10th-grade students (15 to 16 years old) carried out in 2002 and 2017. The questionnaires included self-reported height and weight, questions covering mental health using the Strengths and Difficulties Questionnaire (SDQ), lifestyle, and sociodemographic variables. We estimated the associations between SDQ subscale scores and BMI and the prevalence of overweight and obesity in linear and logistic multivariable models. We also estimated the extent to which gender modified these associations. Results: BMI was positively associated with peer problems [beta (β): 0.08, (95% confidence interval 0.01, 0.14)], indicating that for every point increase in peer problems subscore, BMI increased by 0.08 kg/m2. The association between internalizing (i.e., peer and emotional) problems and BMI and conduct problems and BMI was different for boys and girls (p < 0.05 for all effect modifications). Conclusion: In this repeated cross-sectional study across 15 years, we found that peer problems were associated with BMI in Norwegian adolescents. We also found that there is a possibility that adolescent boys and girls report different mental health symptoms related to increased BMI. This finding implicates a need for gender-specific attention when assessing risk factors for increased BMI in adolescents. Keywords: SDQ; adolescence; body mass index; gender; mental health problems; obesity; overweight. Copyright © 2020 Bjertnaes, Fossum, Oma, Bakken, Arne and Holten-Andersen.

• Bjertnæs, Asborg Sine Aanstad; Schwinger, Catherine; Juliusson, Petur Benedikt; Strand, Tor A; Holten-Andersen, Mads Nikolaj & Bakken, Kjersti Sletten (2020). Health-related behaviors in adolescents mediate the association between subjective social status and body mass index. International Journal of Environmental Research and Public Health (IJERPH).  ISSN 1661-7827.  17(19), s 1- 16 . doi: 10.3390/ijerph17197307 Fulltekst i vitenarkiv. Vis sammendrag

  The aim of this study was to explore the association between adolescent subjective social status (SSS) and body mass index (BMI) at two different time points and to determine whether this association was mediated by health-related behaviors. In 2002 (n = 1596) and 2017 (n = 1534), tenth-grade students (15-16 years old) in schools in the District of Oppland, Norway, completed a survey. Four categories of perceived family economy were measured as SSS, and structural equation modeling was performed, including a latent variable for unhealthy behavior derived from cigarette smoking, snuff-use, and alcohol-drinking as well as dietary and exercise as mediators. No linear association was found between SSS and BMI in 2002 (standardized ß -0.02, (95% confidence interval (CI) -0.07, 0.03)). However, an association was present in 2017 (standardized ß -0.05 (95% CI -0.10, -0.001)), indicating that BMI decreased by 0.05 standard deviations (0.05 × 3.1 = 0.16 BMI unit) for every one-category increase in SSS. This association was mediated by exercise (standardized ß -0.013 (95% CI -0.02, -0.004) and unhealthy behavior (standardized ß -0.009 (95% CI -0.002, -0.04)). In conclusion, a direct association between SSS and BMI was found in 2017 in this repeated cross-sectional survey of 15-16-year-old Norwegian adolescents. This association was mediated through health-related behavior. Keywords: adolescents; body mass index; health behavior; obesity; structural equation modeling; subjective social status.

• Holten-Andersen, Mads Nikolaj; Haugen, Johanne; Oma, Ingvild & Strand, Tor A (2020). Vitamin D Status and Its Determinants in A Paediatric Population in Norway. Nutrients.  ISSN 2072-6643.  12 (5)(5) . doi: 10.3390/nu12051385 Fulltekst i vitenarkiv. Vis sammendrag

  Recommendations for sufficient vitamin D intake in children were recently revised in Norway. However, optimal levels of vitamin D are still debated and knowledge on supplementation and vitamin D levels in healthy children in Norway is scarce. Therefore, we measured the plasma-concentration of 25-hydroxyvitamin D (25(OH)D) in children and adolescents attending the outpatient paediatric clinics in Innlandet Hospital Trust, Norway during two consecutive years (2015–2017). We recruited 301 children and adolescents aged 5 months to 18 years (mean 7.8, SD 4.4 years) for the study and obtained sample material for 25(OH)D measurements from 295 (98%). Information on diet, vitamin D supplementation, sun exposure, ethnicity, parental education and general health was collected by questionnaire. 25(OH)D levels were analysed and determinants for 25(OH)D were estimated by linear regression. 1.0% of the children had deficient levels (25(OH)D < 25 nmol/L) and 21.0% had insufficient levels (25–50 nmol/L). 25(OH)D levels ranging from 50 to 75 nmol/L were found among 38.3%, while 39.7% had levels above 75 nmol/L. The mean 25(OH)D level was 70.0 nmol/L (SD 23.4, range 17–142 nmol/L) with a significant seasonal variation with lowest levels in mid-winter and highest in late summer. In addition to seasonal variation independent determinants for 25(OH)D-levels were age of the child, parental ethnicity, vitamin D supplementation and soda consumption. Along with parental ethnicity other than Nordic, age was the strongest determinant of 25(OH)D, with adolescents having the lowest levels. View Full-Text Keywords: vitamin D; 25(OH)D; child; adolescent; age; ethnicity

• Bjertnæs, Asborg Sine Aanstad; Grundt, Jacob Holter; Donkor, Hilde Mjell; Juliusson, Petur Benedikt; Wentzel-Larsen, Tore; Vaktskjold, Arild; Markestad, Trond & Holten-Andersen, Mads Nikolaj (2019). No significant associations between breastfeeding practices and overweight in 8-year-old children. Acta Paediatrica.  ISSN 0803-5253.  109(1), s 109- 114 . doi: 10.1111/apa.14937 Fulltekst i vitenarkiv. Vis sammendrag

  Abstract Aim: The aim was to examine if breastfeeding practices were associated with body mass index (BMI) and risk of overweight or obesity in third grade (8 years) of elementary school. Methods: In a regional cohort, we related BMI z‐scores and presence of overweight or obesity at 8 years of age with ever being breastfed and with duration of exclusive and partial breastfeeding after adjusting for potential confounders. Parents completed questionnaires on breastfeeding and sociodemographic and lifestyle factors at school entry, and public health nurses measured height and weight. For non‐participants, the nurses anonymously reported these measurements together with sex and age. Results: 90% of participants had been breastfed. In adjusted analyses, BMI z‐scores were not significantly related to whether or not the child had been breastfed (P = .64), or to the duration of exclusive (P = .80) or partial breastfeeding (P = .94). Logistic regression also showed no significant association between breastfeeding measures and overweight or obesity. Conclusion: This study on 8‐year‐old Norwegian children did not support a commonly held notion that breastfeeding reduces the risk of overweight or obesity. K E YWORDS BMI z‐score, breastfeeding, child, obesity, overweight

• Bjertnæs, Asborg Sine Aanstad; Grundt, Jacob Holter; Juliusson, Petur Benedikt; Markestad, Trond Jacob; Strand, Tor A & Holten-Andersen, Mads Nikolaj (2019). Sex-related change in BMI of 15- to 16-year-old Norwegian girls in cross-sectional studies in 2002 and 2017. BMC Pediatrics.  ISSN 1471-2431.  19(431), s 1- 9 . doi: 10.1186/s12887-019-1790-2 Fulltekst i vitenarkiv. Vis sammendrag

  Background: The prevalence of overweight and obesity (OWOB) has stabilized in some countries, but a portion of children with high body mass index (BMI) may have become heavier. This study aimed to describe the distributions of BMI and the point prevalence of OWOB in Norwegian adolescents in 2002 and 2017. Methods: A cross-sectional study involving 15- to 16-year-old adolescents in Oppland, Norway, was undertaken in 2002 and 2017. We calculated their BMI, BMI z-scores (BMIz), and the prevalence of OWOB. Results: The mean BMI increased from 20.7 to 21.4 (p < 0.001) for girls but remained unchanged at 21.5 vs 21.4 (p = 0.80) for boys. The prevalence of OWOB increased from 9 to 14% among girls (difference 5, 95% CI: 2, 8) and from 17 to 20% among boys (difference 3, 95% CI: − 1, 6%). The BMI density plots revealed similar shapes at both time points for both sexes, but the distribution for girls shifted to the right from 2002 to 2017. Conclusion: Contrary to previous knowledge, we found that the increase in OWOB presented a uniform shift in the entire BMI distribution for 15–16-year-old Norwegian girls and was not due to a larger shift in a specific subpopulation in the upper percentiles. Keywords: Adolescent, Body mass index, Body mass index distribution, Obesity, Overweight, Sex differences

• Degirmenci, Naim; Fossum, Ingrid Nesdal; Strand, Tor A; Vaktskjold, Arild & Holten-Andersen, Mads Nikolaj (2018). Consumption of energy drinks among adolescents in Norway: a cross-sectional study. BMC Public Health.  ISSN 1471-2458.  18(1391) . doi: 10.1186/s12889-018-6236-5 Fulltekst i vitenarkiv. Vis sammendrag

  Background Energy drink (ED) consumption is increasing all over the world. We sought to describe the consumption of EDs among adolescents in Norway, and to explore the determinants of daily and high consumption. Methods Population-based cross-sectional data were collected from a sample of 31,091 secondary school students in grade 8–13 aged 12–19 years. School grade, residency, socioeconomic status (SES), physical activity and leisure screen time were included in multiple regression analyses, in order to investigate their associations with daily and high (≥four times weekly) ED consumption. Results 52.3% of the respondents were ED consumers and 3.5% were high consumers. Boys consumed twice as much ED as girls (boys: 36.3 ml/day, girls: 18.5 ml/day, geometric means), and the proportion of male high consumers was 3.7-times higher than that of females. The adjusted odd ratio (OR) of upper secondary school (grades 11–13, ages 15–19) students being high ED consumers were higher than for lower secondary school (grades 8–10, ages 12–15) students (OR 1.1(confidence interval (CI):1.0–1.3)), as well as higher for rural than urban residents (OR 1.3 (CI: 1.1–1.5)). Gradients for the increased ORs of being a high ED consumer were found for decreased SES, decreased frequency of physical activity and increased daily leisure screen time. Conclusions More than half of the respondents reported that they were ED consumers. Daily and high consumption were independently associated with male gender, physical inactivity, high leisure screen time, low socioeconomic status and rural residency.

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